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The Uriscreen Test to Detect Significant A symptomatic Bacteriuria During Pregnancy

James M. Roberts, MD

Matemal-Fetal Unit, Department of Obstetncs and Gynecology, Dr. Domingo Luciani Hospital, Caracas, Venezuela; Magee-Women's Research Institute and Department of Obstetncs, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania

Background: Asymptomatic bacteriuria (ASB) occurs in ²-¹¹% of pregnancies and it is a clear predisposition to the development of acute pyelonephritis, which, in turn, poses risk to mother and fetus. Treatment of bacteriuria during pregnancy reduces the incidence of pyelonephritis. Therefore, it is recommended to screen for ASB at the first prenatal visit. The gold standard for detection of bacteriuria during pregnancy is urine culture, but this test is expensive, time-consuming, and labor-intensive.

Objective: To determine the reliability of an enzymatic urine screening test (Uriscreen; Savyon Diagnostics, Ashdod, Israel)for detecting ASB in pregnancy.

Methods: Catheterized urine samples were collected from 150 women who had routine prenatal screening for ASB. Patients with urinary symptoms, active vaginal bleeding, or who were previously on antibiotics therapy were excluded from the study. Sensitivity, specificity, and the positive and negative predictive valuesfor the Uriscreen were estimated using urine culture as the criterion standard. Urine cultures were considered positive if they grew > 105 colony-forming units of a single uropathogen.

Results: Twenty-eight women (18. 7%) had urine culture results indicating signficant bacteriuria, and 17 of these 28 specimens had positive enzyme activity. Of 122 samples with no growth, 109 had negative enzyme activity. Sensitivity, specificity, and positive and negative predictive valuesfor the Uriscreen test were 60. 7% (± 18. 1), 89.30% (± 5.6), 56.66%, and 90.88%, respectively.

Conclusion: The Uriscreen test had inadequate sensitivity for rapid screening of bacteriuria in pregnancy.

Key Words: Uriscreen • asymptomatic bacteriuria • pregnancy

Journal of the Society for Gynecologic Investigation, Vol. 12, No. 1, 50-53 (2005)
DOI: 10.1016/j.jsgi.2004.07.007


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